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HomeMy WebLinkAboutDriveway Permit - 10/7/08 "EXHIBIT B" FOR CITY USE ONLY DRIVEWAY PERMIT PERMIT # p!— _4 J DATE J - -D ( APPLICANT NAME: s . i J !v �� fir} L OWNER NAME: 5 r1 M F PROPERTY ADDRESS: 1 =1 3 u 3 C_ v AC_ to f\ A LA NI E N G TO CONSTRUCT: ❑ New A Replace ❑ Widen TYPE OF PROPERTY: , IS)I Residential ❑ Commercial ❑ Industrial Proposed width of temporary or permanent drive way r Fi M. (Please provide sketch on reverse side or on separate sheet) Type of Material �S i�►�aL ( W / �� - (¢ Is property within the Shoreland District ?I Yes ❑ No (If yes, applicant must submit impervious surface calculation) P � The driveway is proposed off what roadway? L 0 �.�r1M i4v.1 j. A N 'r Is driveway shared by another property owner? ❑ Yes No (If yes, signature of all parties is required) Estimated Start Date 0 Cr - , t? Estimated Completion Date \Q 't + }.l 1,3 J. w't&$ SKETCH REQUIREMENTS 1. A driveway sketch is required as a part of this permit. The sketch can be drawn on page two of the permit or on a separate sheet. The sketch does not need to be drawn to scale, however dimensions must be provided on sketch. 2. Driveway sketch should include proposed driveway, existing driveway (dashed line), driveway dimensions, property lines, dimensions of driveway from property lines, building locations near driveway, arrow indicating north, surface features near proposed driveway location (trees, hydrants, utilities, etc.). 3. If on a corner lot, the sketch should include dimensions to intersecting roadways. CONDITIONS OF APPROVAL 1. No work under this application is to be started until application is approved and the permit is issued. 2. Where work on traveled roadway is necessary, traffic must be protected and flags, signs, safety cones and proper barricades must be placed in accordance with safety procedures. 3. No foreign material such as dirt, gravel, or bituminous material shall be left or deposited on the road during the construction of driveway. 4. Road must be swept clean after work is completed. 5. Prior to placement of concrete or bituminous surfacing, the applicant shall notify the Engineering Department at 952- 447 -9830 that the work has been completed and is ready for final inspection. 6. No changes or alterations in entrances may be made at any time without written permission from the Engineering Department. %are " "EXHIBIT B" 7. Permit expires 90 days after approval date. 8. Additional Conditions IMPORTANT: Before starting work... The Applicant shall call Gopher State One Call (1- 800 - 252 -1166) 48 hours prior to starting work. Applicant must call the Engineering Department (952) 447 -9830 for inspection 24 hours prior to time of inspection. As provided in Ordinance Numbers 1107.205 & 1107.206 I, We the undersigned, herewith make application for permission to construct the driveway at the above location, said driveway to be constructed to conform with the standards of the City of Prior Lake and to any special provisions included in the permit. It is agreed that all work will be done to the satisfaction of the Engineering Department. It is further agreed that no work in connection with this application shall start until the application is approved and the perm 't issued. i e4^ l[-e \--1„ �\ A.JA..-k./C Contractor Applicant's Signature r Date: t / - 1 O FOR CITY USE ONLY AUTHORIZATION OF PERMIT Permit Fee $ M / ° • `� `' In consideration of agreement to comply in all respects with the regulations of the City of Prior Lake covering such operations, and pursuant to authorization duly given by said City of Prior Lake, permission is hereby granted for the work to be done as described in the above application and submitted drawings, said work to be done in accordance with this application and submitted drawings. ENGINEERING OFFICIAL -'2. / Date / 0/ 1 / o Permit is valid if signed by City Official Permit Expiration Date (90 days from approval date) t 1 "7 fo5 oaf' -IT/ Home Improvement Agreement: Concrete Job Specifications 5 shoe/ : mm-e.,. 4'3o 3 (c4)flab1 (14 _ yl Customer's Last N mp First Name Store No. Order No. — a . 7 — 71 -r nn r ‘..0.10. , firtl 5-5-3 7 Detailed drawing, including location of house and project area dimensions - shia■I■■■■ ■1111■11Fw: 11111111111M13111111111121111 i1I11111111121111 ■ ■ ■ ■ ■11.U11i 11dI1.11111... ■1111111. ■ ■ ■11 ■ 1111M111111•11111111111M1111111111 ii ■I..s.■■■.■u11■ .4— ■ ■ ■■ ■ ■- e_:.�_ l 11111111111EmemmuEM ■«r, ■■■■■ 1r1111■1e11■111111•1:1111■u ■■llii■rou■■ 111111111v ■n11■■1I !!� O111 \ ■111irrA1 ■1131 tj,116 r.11■ 1!. ■ ■L111 S1 11■ 11x1. APIRmapir onno. � li®F 11 ■■u.. ■1111 ■■11 ■ ■ ■■ 1�i• . ■ •■■ 1111 ■ ■11■ ■11■Usa■■ ■■••11 ■1■ ■•■ ■ • •1 ■ ©�_ ■ ■■ 11■ ■l� 1 ■11 ■■�iu ! IT` ■u■ ■�� -- o u011211 ZEZE ■ ■ ■■ 1111■ M.r ' ! ■ ■ ■ v'', M11111111111111111111111111111111111111•11•1111111111111111111111111•11111 - FtWiNalgnEPUIPETT12 ■ ■■ ■■ ■I ■ ■ ■em iiiarai iumni1111■ ■ ■u■ a■■ ■■ ■11.11 ■mI -E-onsirztlknr..,12rerasnniciltneumanme11111111111111 o--- 1�!1' AT11115110111t071111!C1111111■■ 111111111111111111111111 11111111111111111111111111111111111111111111111111111111111211 -- 11111M1,11111111111111WA1111111111111111111111111111111111111111111 ■I i1i ■111111 1_ I� !!!!!! ? E! 1111 ■■ ■ ■11�■ ■ ■ ■■1 ■ ■ ■ ■ ■il it 111111 ■I■__ ■ ■_ -- .mil -- - LIE =1 �Ilt��li�l.�.ri�a�.a� ■■ ■1111 ■1111■1111■ ■ ■■ ■ ■ ■111■■■■1111■ ■ ■■I LSAIN !IIIII■■■■■■■■■■ II11 II■■■_I 1■ l _- 111111i11•li■ I/ i_ lrt•__ N11_- 1 .■11111111ilwl.11111_lal._lll■.ill.■I■1.IIIIIIIIE . r� Total Sq. Ft: , r Est. # of Yards: . _ !! . i + 1 ... Est. # of days to complete: Z' 3 Requested to Date: Total Installation Price Quote*: $ •��� . oO 3, /e / 1 3 ' *Price Quote is only applicable for services i s1 ted on this Concrete Job Specifications sheet and does not include potential price increases due to change orders not detailed on this sheet. Price quoted is subject to change 30 days after measure date. Intfrillation Professional's Full ame: , Cow T S /a 5a77-r Installation Professional's Tel No.: .952 -02 z -/ Accep d by: `,- Submitted by: X O �� 7 . Pa X +y . 1 I /O A % Customgr' Signature Date Professional Authorized presentativ Full Sig re Date w•` Horne Depot U.S.A. Inc., 2455 Paces Ferry Road, N.W., Bldg. 8.3, Atlanta, Georgia 30339 HD- 273(7/5/07) DISTRIBUTION: White—Home Depot Copy Yellow— Customer Copy Pink— Installation Professional Copy '